A Randomized Controlled Trial of Two Interventions to Improve Medication Reconciliation

Abstract

Medication errors and adverse drug events are common in outpatient settings. A meta-analysis of 29 studies found an incidence of about 15 adverse drug events per 100 outpatients per year, of which 20% were judged as being preventable.1 In a sys-

Evaluation of Multimedia Medication Reconciliation Software: A Randomized Controlled, Single-Blind Trial to Measure Diagnostic Accuracy for Discrepancy Detection

“…41,46,68,73,84 Several possibilities may explain why our study detected more discrepancies than most other MR studies published in the last 5 years (34-88%). 25,27,37,46,47,72,85,86 First, Veterans tend to be older, more medically complex, and take more medications than the general population. Each of these factors has been shown to correlate with the incidence of medication errors.…”

“…Clinician engagement, standardized processes, and patient-centered strategies may have greater influence upon the accuracy, quality, and overall success of MR than any specific technology. 85 Most MR methods-including paper-may be equifinal if informaticians optimize workflow and implementation climate (i.e., culture, leadership, and education). Nonetheless, facilities contending with staff shortages, high patient volumes, or large geographic areas may consider using patient-centered technologies such as kiosks, secure messaging, or online portals to improve efficiency and scalability without sacrificing effectiveness or accuracy.…”

“…To the best of our knowledge, there are very few published studies comparing MR strategies and only four other randomized controlled trials (RCTs) conducted in the ambulatory setting, none of which adhere to the CONSORT/STARD guidelines. 19,21,47,74,85,86,96,[98][99][100] Systematic reviews of ambulatory MR programs suggest more research is needed to prove the clinical impact of MR. 21,27,74,96,98,101 Our study makes an important contribution to the literature by providing accuracy statistics for multiple collection strategies.…”

Drug use among men with unfulfilled wish to father children: a retrospective analysis and discussion of specific drug classes

“…Additionally, we presume that patients often did not report all drugs and recreational products, even on request. Studies on medication reconciliation showed that the way questions are phrased strongly influences the number of reported drugs . In addition, we found documented diseases requiring treatment without mention of a corresponding drug.…”

“…Studies on medication reconciliation showed that the way questions are phrased strongly influences the number of reported drugs. [55][56][57][58] In addition, we found documented diseases requiring treatment without mention of a corresponding drug. Another limiting factor was the poor quality of information on potential ADRs on male fertility.…”